Lichen Planus Treatment in Jammu

Is lichen planus contagious?

No. Lichen planus is not contagious.

It cannot spread through:

• Touching
• Sharing towels
• Food
• Kissing
• Sexual contact
• Swimming
• Living in the same household

Lichen planus is an inflammatory condition rather than a bacterial, fungal or viral infection that passes from one person to another.

Is genital lichen planus a sexually transmitted infection?

No. Genital lichen planus is not an STI.

However, genital disease can cause soreness, burning, erosions and pain during sexual activity. It may resemble infection, allergy, lichen sclerosus or another genital condition, so diagnosis should be confirmed before treatment.

Can medicines cause a lichen-planus-like rash?

Yes. Some medicines can produce a lichenoid drug eruption, which resembles lichen planus.

The rash may begin weeks or months after a medicine was started. A careful review of prescription medicines, non-prescription drugs and supplements is therefore part of assessment.

Patients should not stop an important prescribed medicine independently. The suspected relationship should be discussed with the dermatologist and the original prescribing doctor.

What does lichen planus look like on the skin?

Classic skin lichen planus may produce:

• Small, raised bumps
• Flat-topped lesions
• Purple, violet, brown or grey colour
• Fine white lines on the surface
• Intense itching
• Groups of closely packed bumps
• Thickened plaques
• Ring-shaped lesions
• Dark marks after healing

The wrists, ankles, lower back and legs are commonly affected, although lesions can appear elsewhere.

How does lichen planus appear on Indian skin?

On medium-to-deep Indian skin tones, lichen planus may appear:

• Dark brown
• Purple-brown
• Violet
• Grey
• Nearly black
• Less visibly red than expected

After the active bumps settle, dark post-inflammatory marks may remain for months or occasionally longer. These marks are more frequent and can be more noticeable in darker skin tones.

What are Wickham striae?

Wickham striae are fine white or grey lines seen across the surface of some lichen planus bumps or oral lesions.

They may create a:

• Lacy pattern
• Net-like pattern
• Branching pattern
• Fine white surface marking

Their presence can support the diagnosis, but they may be subtle or absent.

Can lichen planus develop after scratching or injury?

Yes. New lesions can sometimes develop along an area of skin injury, known as the Koebner phenomenon.

Possible triggers include:

• Scratching
• Cuts
• Friction
• Burns
• Surgical scars
• Tattoos
• Repeated rubbing

Reducing scratching and protecting inflamed skin can help limit further injury.

Does skin lichen planus clear naturally?

Skin lichen planus may improve without treatment, particularly when disease is mild and limited.

Many cutaneous cases clear over approximately one to two years, although the timeframe varies. Dark marks may remain after the raised lesions have resolved. Oral, genital, scalp and nail lichen planus can last longer and may need active treatment or monitoring.

What are the types of oral lichen planus?

Reticular oral lichen planus

This form causes white lacy lines or small white patches and may produce little or no discomfort.

Erosive oral lichen planus

This form causes raw, red, ulcerated or painful areas.

Atrophic oral lichen planus

The lining appears thin, inflamed and sensitive.

Plaque-like oral lichen planus

Thicker white patches may develop and need differentiation from other oral conditions.

Different patterns can occur together.

What symptoms can oral lichen planus cause?

Possible symptoms include:

• Burning
• Stinging
• Mouth soreness
• Pain while eating
• Sensitivity to spicy food
• Sensitivity to acidic food
• Bleeding gums
• Pain during brushing
• Painful ulcers
• Altered taste
• Dry or uncomfortable mouth

Symptoms may fluctuate, with periods of improvement followed by flare-ups.

Does oral lichen planus increase the risk of oral cancer?

Oral lichen planus carries a small but clinically important potential for malignant change, particularly in persistent red, erosive or ulcerated disease.

Published estimates vary because studies use different diagnostic criteria and may include oral lichenoid lesions that are not identical to true lichen planus. Reviews using strict criteria have reported lower transformation rates than broader studies, but regular examination remains appropriate.

A persistent ulcer, lump, hardened area, unexplained bleeding or changing lesion should be examined promptly and may require biopsy.

Which oral changes require prompt reassessment?

Arrange timely review for:

• An ulcer that does not heal
• A lump or thickened area
• Increasing pain
• Unexplained bleeding
• A change in colour or surface
• Difficulty swallowing
• Persistent hoarseness
• Reduced tongue movement
• Unexplained weight loss
• Enlarged neck lymph nodes

These changes do not automatically mean cancer, but they should not be attributed to routine lichen planus without examination.

Why are dental check-ups important?

Good dental and gum health can reduce additional irritation in an already sensitive mouth.

Patients with oral lichen planus may be advised to:

• Brush gently twice daily
• Use a soft toothbrush
• Floss or use an appropriate interdental cleaner
• Attend regular dental examinations
• Have professional cleaning as advised
• Address sharp teeth or poorly fitting dental appliances
• Avoid toothpaste that repeatedly burns or irritates

Ongoing review by a dermatologist, dentist or oral-medicine clinician may be appropriate according to the disease pattern.

Which foods may irritate oral lichen planus?

During an active flare, discomfort may worsen with:

• Spicy food
• Acidic food
• Citrus fruit
• Very salty food
• Hard or crunchy food
• Very hot drinks
• Alcohol
• Tobacco

Patients do not need to remove every item permanently. The goal is to avoid foods that repeatedly cause pain while maintaining a balanced diet.

Can dental materials trigger a lichenoid reaction?

Some oral lichenoid lesions may develop next to a dental material or another local irritant.

Assessment may consider:

• Dental fillings
• Metals
• Dental appliances
• Toothpaste ingredients
• Mouthwash
• Cinnamon or flavouring agents
• Repeated mechanical trauma

Removal or replacement of dental work should not be undertaken without coordinated dental and dermatological assessment.

What is lichen planopilaris?

Lichen planopilaris is lichen planus affecting the scalp hair follicles.

It can cause:

• Scalp itching
• Burning
• Tenderness
• Redness around hair follicles
• Perifollicular scale
• Patchy hair loss
• Loss of follicular openings
• Permanent scarring alopecia

Unlike alopecia areata, lichen planopilaris can destroy follicles permanently. Treatment aims primarily to stop inflammatory progression and preserve remaining hair.

Why is early diagnosis of lichen planopilaris important?

Hair that has already been lost because of follicular scarring may not regrow.

Early treatment may:

• Reduce itching and burning
• Control scalp inflammation
• Slow extension of bald areas
• Protect follicles that remain
• Reduce permanent hair loss

A painful, burning or scaly area of scalp hair loss should therefore be assessed without waiting for it to become large.

How is lichen planopilaris different from alopecia areata?

• Is a scarring alopecia
• May cause scalp burning or tenderness
• Produces inflammation and scale around follicles
• Can permanently destroy follicles
• Often requires biopsy when uncertain

• Is usually non-scarring
• Commonly produces smooth bald patches
• Preserves follicular openings
• Allows potential regrowth
• May affect nails, eyebrows or beard

The consultation can include the skin, mouth, scalp, nails and genital symptoms rather than treating only the most visible rash.

Lichen planus is distinguished from eczema, psoriasis, fungal infection, lupus, lichenoid drug eruption and other similar conditions.

Skin biopsy is available at both branches for selected uncertain, scarring or changing lesions.

Scalp and nail lichen planus can cause permanent damage, making timely diagnosis especially important.

Treatment is planned under Dr. Cheena Langer, MBBS, MD Dermatology, Consultant Dermatologist.

Persistent erosive mucosal disease is followed for symptom control, scarring and suspicious changes.

General dermatology consultation is available at both Karan Nagar and Paloura.

Additional cost depends on:

• Body area affected
• Topical medicine
• Mouth rinse, gel or paste
• Corticosteroid injections
• Skin, scalp, nail or oral biopsy
• Blood tests
• Treatment of secondary infection
• Systemic medicine and monitoring
• Dental or oral-medicine review
• External phototherapy
• Follow-up after the included 10-day period

Skin-only lichen planus generally requires a different plan from erosive oral disease, progressive nail damage or scarring scalp involvement.